Borzecki et al:1 retrospective, observational 2-yr study found a reduction in all-cause mortality with sevelamer vs. calcium carbonate, 0.67 (0.54 to 0.84). Barreto et al. 2008. Nephron Clin Pract. 110(4):c273-c283Author's warning, "The protocol was not designed to look at mortality impact... the interpretation of this information may be misleading."J Clin Pharm Ther; 2007; 32:617-24Many clinicians are skeptical of the results from this meta-analysis.Clin J Am Soc Nephrol 2016 (11): 232–244

Population:Adults with CKD stages 3 to 5D (n=4,770)Intervention: meta-analysisRCTs and quasi-randomized trials published in MEDLINE and Cochrane central register from March 2009 to March 2015Comparator:Calcium salts vs. sevelamer Outcome:Sevelamer had lower all-cause mortality, RR 0.54, (0.32 to 0.93)No difference in CV mortality or GI side effectsCommentaryAgain, 7 of 9 studies